Aviation Class 1 & Class 2 medical - London.

Every pilot, cabin crew member and air traffic controller flying under a UK CAA or EASA licence holds a statutory medical certificate. It is issued only by a CAA-approved Aeromedical Examiner (AME) or, for the first Class 1 initial, at an Aeromedical Centre (AeMC). The classes map directly to the licence you fly on: Class 1 for commercial operations (ATPL, CPL, MPL), Class 2 for private pilots (PPL), LAPL for the Light Aircraft Pilot Licence, CC medical for cabin crew, and a separate ATCO certificate for air traffic controllers. Balloon and glider pilots use LAPL or a self-declared medical depending on operation.

The medical is not the same as a routine GP check-up. It is a fitness-for-duty assessment against a defined regulatory standard, and an AME can only issue, defer to the CAA Medical Advisory Service, or refuse. A private consultant cannot substitute their opinion.

The Class 1 initial is the most comprehensive medical in the CAA framework. Expect a two to three hour appointment covering: full history and physical examination, pure-tone audiogram, resting 12-lead ECG, chest X-ray (initial only, then five-yearly), urinalysis, haemoglobin, lipid profile, blood glucose, full vision workup (distant, intermediate, near visual acuity, phorias, colour vision), spirometry, height, weight and blood pressure. Initial Class 1 is normally issued at an approved AeMC.

Renewals are streamlined. Under 60 years old: annual renewal with an ECG every 24 months (or every 12 months from age 40). From 60 onwards: six-monthly renewals with an annual ECG, and audiometry every four years. A revalidation appointment typically takes 45 to 75 minutes.

Class 2 is less comprehensive than Class 1 but still a full aeromedical examination. Initial: history and physical, vision (distant, near, intermediate, colour vision), hearing (conversation and audiogram if indicated), cardiovascular assessment, blood pressure, urinalysis, and a resting ECG from age 50 (or earlier if clinically indicated). Renewals run five-yearly under age 40, two-yearly from 40 to 49, and annually from 50 onwards. ECG is repeated every two years from age 50.

The LAPL medical is deliberately lighter than Class 2 and can be issued by a GP with CAA registration as well as by an AME. Assessment covers a general medical history, blood pressure, vision, hearing, and a review of any medications. Validity is 60 months under 40, 24 months from 40 to 49, and 12 months from 50 onwards. LAPL is a sensible route for recreational pilots flying non-complex single-engine aircraft under EASA rules.

All classes are screened with the 24-plate Ishihara test. If Ishihara is failed, secondary testing decides your outcome. For Class 1 that means the CAD (Colour Assessment and Diagnosis) test at Gatwick or an approved lantern test (Spectrolux, Beynes). Class 2 and LAPL may proceed on a lantern pass with a "day-only, no night flying, no colour signals" restriction. A failed CAD does not always end a commercial career, but it usually caps it at multi-crew operations.

The CAA publishes long lists, but the practical picture is this. Absolute or near-absolute barriers include: untreated hypertension consistently above 160/100, any arrhythmia associated with syncope or haemodynamic compromise, active epilepsy or a single unprovoked seizure within the last ten years (Class 1) or five years (Class 2), insulin-treated diabetes on Class 1 (individually assessed only), acute DVT or pulmonary embolism until fully anticoagulated and stable, stimulant medication for ADHD on Class 1, and most SSRIs pending individual CAA review with a stability period.

Many other conditions look scary on paper but are compatible with certification once documented: well-controlled hypertension on approved medication, treated hypothyroidism, laser eye surgery after a stability period, coronary stents after 12 months and normal functional testing, and treated obstructive sleep apnoea with CPAP compliance data. Always declare in full - an undeclared condition uncovered later invalidates the certificate and the insurance behind it.

Where every criterion is met on the day, the AME issues the certificate at the end of the appointment - printed, signed, and valid immediately. Borderline findings (an unexpected ECG change, a new medication needing review, a colour vision fail requiring CAD) are deferred to the CAA Medical Advisory Service, which typically takes two to eight weeks to respond. Your existing certificate normally remains valid during that review unless the AME judges otherwise.

Central London and Home Counties AMEs we regularly refer to include Fleet Street Aviation Medicine, London Aviation Medical (Harley Street), and Nightingale Aviation Medicine. Class 1 initials must be at a CAA-approved AeMC - most candidates use Heathrow Medical Services or the CAA Aeromedical Centre at Gatwick. A full list of active AMEs is published on the CAA website.